Youth Violence and Connectedness in Adolescence: What Are the Implications for Later Sexually Transmitted Infections?

PurposeTo examine associations between (1) youth violence victimization and perpetration and later sexually transmitted infections (STI) and (2) parent–family and school connectedness and later STI, and to explore the moderating role of connectedness on the associations between youth violence victimization and perpetration and later STI.MethodsWe used data from Waves I and IV of the National Longitudinal Study of Adolescent Health, which provided a baseline weighted sample of 14,800 respondents. We used logistic regression to examine associations between youth violence and connectedness with self-reported ever STI diagnosis, including gonorrhea, chlamydia, syphilis, genital herpes, genital warts or human papillomavirus, or human immunodeficiency virus. If participants reported having an STI at Wave I they were excluded from the analysis.ResultsControlling for biological sex, race/ethnicity, age, parent's highest education level, and parent's marital status, both youth violence victimization and perpetration were associated with an increased risk of later STI (adjusted odds ratio [AOR], 1.27, 95% confidence interval [CI], 1.07–1.52; and AOR, 1.21, 95% CI, 1.04–1.41, respectively). Parent–family and school connectedness in adolescence were associated with a decreased risk for later STI (AOR, .96, 95% CI, .95–.98; and AOR, .97, 95% CI, .95–.99, respectively); however, connectedness did not moderate the associations between nonsexual violence involvement and later STI.ConclusionsThese results indicate that youth violence victimization and perpetration may be risk factors for STI later in life. Conversely, parent–family and school connectedness in adolescence appear to protect against subsequent STI. The findings suggest that provider efforts to address youth violence and connectedness in adolescence can promote positive sexual health outcomes in adulthood.     

Attitudes about Violence and Involvement in Peer Violence among Youth: Findings from a High-Risk Community

Peer violence perpetration and victimization are the most common types of violence among youth. This study determined the associations among violent attitudes toward peers, involvement in peer violence perpetration, and experience with peer violence victimization among boys and girls in a high-risk, urban community. Analyses were based on data from the 2004 Youth Violence Survey, which was administered to over 80% of public school students in grades 7, 9, 11, and 12 (N = 4,131) in a disadvantaged, urban, school district in the USA. Logistic regression analyses were conducted to test the associations between attitudes in support of violence and involvement in violent behaviors. Results show that among youth, attitudes supporting boys hitting boys significantly increased the odds of peer violence perpetration after controlling for potential confounders (adjusted odds ratio [AOR], 1.35; 95% confidence interval [CI] = 1.07, 1.72). However, stratified analyses for boys and girls show that attitudes supporting boys hitting boys increased the odds of peer violence perpetration for girls only after controlling for potential confounders (AOR, 1.49; 95% CI = 1.05, 2.13). The findings demonstrate that there are important differences between boys and girls in terms of their associations with violent attitudes and involvement in actual violent behaviors. However, additional research is needed to determine how attitude modifications can be incorporated into youth violence prevention programs.     

Gender-Equitable Attitudes,Bystander Behavior,and Recent Abuse Perpetration Against Heterosexual Dating Partners of Male High School Athletes

Objectives. We assessed the relationship between gender attitudes, identified as a critical component of violence prevention, and abuse toward dating partners among adolescent male athletes.Methods. Our sample comprised 1699 athletes from 16 high schools in northern California who were surveyed between December 2009 and October 2010 in the larger Coaching Boys Into Men trial. We used logistic regression to assess the association between gender-equitable attitudes, bystander behavior, and recent abuse incidents.Results. Athletes with more gender-equitable attitudes and greater intention to intervene were less likely (adjusted odds ratio [AOR] = 0.36; 95% confidence interval [CI] = 0.28, 0.46; and AOR = 0.60; 95% CI = 0.48, 0.75, respectively) and athletes who engaged in negative bystander behavior were more likely (AOR = 1.22, 95% CI = 1.10, 1.35) to perpetrate abuse against their female dating partners.Conclusions. Despite the shift among bystander intervention programs toward gender neutrality, our findings suggest a strong association between gender attitudes and dating violence. Programs designed for adolescents should include discussion of gender attitudes and target bystander behavior, because these components may operate on related but distinct pathways to reduce abuse.Adolescent relationship abuse among heterosexual youths is common, with 20% to 25% of adolescents reporting this exposure.1,2 Adolescent relationship abuse is a gendered exposure. Although adolescent boys report experiencing aggression or physical violence from their female dating partners,3 women and girls are more likely to experience such violence, particularly sexual assault, and to experience poor health as a result.4,5 This disparity has been attributed to social norms supportive of male dominance in sexual and dating relationships, normalization of the use of violence as a means of conflict resolution, and the perception that peers support aggressive and abusive behavior.6,7Gender-equitable norms (socially prescribed definitions of masculinity and equitable power in sexual relationships) have been recognized by the global health community as a critical component of violence prevention.8,9 A small body of literature has empirically tested the association of such attitudes with adolescent relationship abuse10,11 and adult intimate partner violence.12 Although attitudes that degrade women and legitimize violence have been shown to be modifiable in men,12–16 limited attention has been paid to addressing norms in the context of dating violence among adolescents.Recent work in the field has focused on the social context of violence by attempting to alter the behavior of men and boys when they witness peers perpetrating physical–sexual abuse, rather than targeting the behavior of individual perpetrators. This bystander intervention approach aims to help witnesses better recognize abusive behaviors and take responsibility to stop them.17–19 Early bystander intervention programs incorporated conversations about masculinity and power into their curricula, the most notable of which was designed for male high school and college athletes.20 The athletic context provided a unique opportunity to implement gender-transformative programming within a culture influenced by discourses of masculinity and power, and the program encouraged athletes to model respectful behavior for peers in the greater school community. Today, discussions of gender norms are largely absent from bystander intervention programs so as not to target individual perpetrators.20 Such gender-neutral programs consider the impact of power imbalances on violence, but the underlying causes of these imbalances are less clearly articulated.In light of the shift in bystander intervention programs toward gender neutrality,20 despite evidence that sexual violence and harassment are influenced by social norms regarding relationships and masculinity,21 we empirically examined the relationships between gender-equitable attitudes, bystander behavior, and abuse toward heterosexual dating partners among a sample of male high school athletes.     

Male Perpetration of Teen Dating Violence: Associations with Neighborhood Violence Involvement,Gender Attitudes,and Perceived Peer and Neighborhood Norms

This study aims to examine the link between male perpetration of teen dating violence (TDV) and neighborhood violence, as well as associations with gender attitudes and perceived peer and neighborhood norms related to violence among a sample of urban adolescent boys. Participants of this cross-sectional study (N = 275) were between the ages of 14 and 20 years and recruited from urban community health centers. Crude and adjusted logistic and linear regression models were used to examine TDV perpetration in relation to (a) neighborhood violence involvement, (b) perceptions of peer violence, (c) perceptions of neighborhood violence, and (d) gender attitudes. Slightly more than one in four (28%) boys reported at least one form of TDV perpetration; among boys who have ever had sex, almost half (45%) reported at least one form of TDV perpetration. In logistic and linear regression models adjusted for demographics, boys who reported TDV perpetration were more likely to report involvement in neighborhood violence (odds ratio (OR) = 3.1; 95% confidence interval (CI) = 1.7–5.5), beliefs that their friends have perpetrated TDV (OR = 2.7; 95%CI = 1.4–5.1), perceptions of violent activity within their neighborhood (OR = 3.0; 95%CI = 1.4–6.3), and greater support of traditional gender norms (β = 3.2, p = 0.002). The findings suggest that efforts are needed to address boys’ behaviors related to the perpetration of multiple forms of violence and require explicit efforts to reduce perceived norms of violence perpetration as well as problematic gender attitudes (e.g., increasing support for gender equity) across boys’ life contexts.     

Associations between interpersonal violence victimisation and concussions among US college students

Interpersonal violence is common on college campuses and is associated with many adverse health outcomes; however, it remains unknown whether experiencing interpersonal violence victimisation is associated with concussions. The aim of this study was to estimate the associations between interpersonal violence, including emotional abuse, physical abuse and sexual assault, and concussions among a large, diverse sample of college students. We analysed cross-sectional data from the 2018–2019 national (US) Healthy Minds Study (N = 1,478). Multiple logistic regression analyses were conducted to estimate the association between interpersonal violence victimisation (any violence victimisation, emotional abuse, physical abuse and sexual assault) and concussion history (any concussion, diagnosed concussion and undiagnosed concussion), while adjusting for potential confounders. Analyses were conducted among the overall sample and separately by male and female participants. Results showed patterns of significant associations between interpersonal violence victimisation and concussions among the overall sample and among male and female participants. Among the overall sample, any interpersonal violence victimisation (adjusted odds ratio [AOR] 1.45, 95% confidence interval [CI] 1.13–1.88), emotional abuse (AOR 1.36, 95% CI 1.06–1.76), physical abuse (AOR 1.61, 95% CI 1.07–2.44) and sexual assault (AOR 2.17, 95% CI 1.44–3.26) were associated with higher odds of any concussion history. Sexual assault victimisation had the strongest association with any concussion history among male (AOR 1.96, 95% CI 1.04–3.71) and female (AOR 2.96, 95% CI 1.62–5.43) participants. These results expand on prior interpersonal violence and concussion research by showing an association with multiple victimisation measures among a large and diverse sample of college students. Medical professionals should screen for concussions among college students who experience emotional abuse, physical abuse and sexual assault to provide appropriate guidance. Information on the symptoms of concussions should be incorporated into campus violence awareness and prevention efforts.     

Intimate partner violence: prevalence and perceptions of married men in Ibadan, Nigeria

In sub-Saharan Africa rates of intimate partner violence (IPV) are high. Thus, identifying reasons for abuse is crucial in ensuring women's health. Hence, mens perception of IPV was assessed, and prevalence of abuse determined. Survey of 820 married men from six urban communities in Ibadan was done using interviewer administered questionnaire. Four focus group discussions were conducted. Lifetime prevalence of perpetration of physical abuse was 25.1%, while psychological violence was 44.4%. Two hundred and forty (29.3%) had ever perpetrated sexual violence and 23.2% economic violence. At least one of these forms of violence had been perpetrated by 44.1% of the respondents. "Being rude" (66.4%) and "insufficient care of the children" (54.3%) were common justifications for IPV. Motive of the abuse were "to make partner responsible" (60.3%) and "to obtain respect" (59.9%). Predictors of perpetrating violence were being in polygamous unions (OR 1.83, 95% CI: 1.11-3.03), consuming alcohol (AOR 1.67; 95% CI: 1.10-2.53), and being Moslem (AOR = 1.87, 95% CI: 1.21-2.910). Men with inadequate knowledge and negative attitudes had greater likelihood of perpetrating IPV (AOR = 2.11, 95% CI: 1.37-3.26 and AOR = 2.09, 95% CI: 1.33-3.27). IPV was also associated with young age. Premarital counseling on how to resolve conflict without resulting to violence and early education of boys on violence to women is recommended.     

Hierarchical Modeling of Psychosocial,Parental, and Environmental Factors for Susceptibility to Tobacco Product Use in 9–10-Year-Old Children

PurposeTobacco use during early adolescence can harm brain development and cause adverse health outcomes. Identifying susceptibility in early adolescence before initiation presents an opportunity for tobacco use prevention.MethodsData were drawn from the Adolescent Brain and Cognitive Development study that enrolled 9–10-year-old children in 21 US cities between 2016 and 2018 at baseline. Separate nested hierarchical models were performed to incrementally examine the associations of sociodemographic factors, psychosocial influences, parental substance use, immediate social contacts, and perceived neighborhood safety with tobacco use susceptibility among never tobacco users (n = 10,449), overall and stratified by gender.ResultsA total of 16.6% of youths who have never used tobacco reported susceptibility to tobacco. Females (vs. males, adjusted odds ratio [AOR] [95% confidence interval {CI}] = 0.80 [0.70–0.91]), positive parental monitoring (AOR [95% CI] = 0.76 [0.66–0.87]) and positive school environment (AOR [95% CI] = 0.95 [0.93–0.98]) were associated with reduced susceptibility to tobacco use. Parental education level (high school, AOR [95% CI] = 1.52 [1.02–2.28]; bachelor's degree, AOR [95% CI] = 1.53 [1.03–2.28]; or postgraduate degree, AOR [95% CI] = 1.54 [1.03–2.3] vs. less than high school), youth substance ever use (AOR [95% CI] = 2.24 [1.95–2.58]), internalizing problems (AOR [95% CI] = 1.03 [1–1.06]), and high scores on negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency-impulsive behavior scale were associated with increased susceptibility to tobacco use. Stratified analysis showed that parent-perceived neighborhood safety was associated with reduced susceptibility to tobacco use among males but not among females (AOR [95% CI] = 0.89 [0.81–0.99]) vs. (AOR [95% CI] = 1.01 [0.9–1.13]). A positive school environment was associated with lower susceptibility to tobacco use among females but not among males.DiscussionParental, environmental, and psychosocial factors influence early childhood tobacco susceptibility. Family and school-based tobacco prevention programs should consider integrating these factors into primary school curricula to reduce youth tobacco susceptibility and later initiation.     

Violence in childhood,attitudes about partner violence,and partner violence perpetration among men in Vietnam

PurposeWe assess the association of men’s exposure to violence in childhood—witnessing physical violence against one’s mother and being hit or beaten by a parent or adult relative—with their attitudes about intimate partner violence (IPV) against women. We explore whether men’s perpetration of IPV mediates this relationship and whether men’s attitudes about IPV mediate any relationship of exposure to violence in childhood with perpetration of IPV.MethodsFive hundred twenty-two married men 18–51 years in Vietnam were interviewed. Multivariate regressions for ordinal and binary responses were estimated to assess these relationships.ResultsCompared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of reporting more reasons to hit a wife (aOR, 1.43; 95% CI, 1.03–2.00 and aOR, 1.66; 95% CI, 1.05–2.64, respectively). Men’s lifetime perpetration of IPV accounted fully for these associations. Compared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of ever perpetrating IPV (aOR, 3.28; 95% CI, 2.15–4.99 and aOR, 4.56; 95% CI, 2.90–7.17, respectively). Attitudes about IPV modestly attenuated these associations.ConclusionsAddressing violence in childhood is needed to change men’s risk of perpetrating IPV and greater subsequent justification of it.     

Effects of the It’s Your Game . . . Keep It Real Program on Dating Violence in Ethnic-Minority Middle School Youths: A Group Randomized Trial

Objectives. We examined whether It’s Your Game . . . Keep It Real (IYG) reduced dating violence among ethnic-minority middle school youths, a population at high risk for dating violence.Methods. We analyzed data from 766 predominantly ethnic-minority students from 10 middle schools in southeast Texas in 2004 for a group randomized trial of IYG. We estimated logistic regression models, and the primary outcome was emotional and physical dating violence perpetration and victimization by ninth grade.Results. Control students had significantly higher odds of physical dating violence victimization (adjusted odds ratio [AOR] = 1.52; 95% confidence interval [CI] = 1.20, 1.92), emotional dating violence victimization (AOR = 1.74; 95% CI = 1.36, 2.24), and emotional dating violence perpetration (AOR = 1.58; 95% CI = 1.11, 2.26) than did intervention students. The odds of physical dating violence perpetration were not significantly different between the 2 groups. Program effects varied by gender and race/ethnicity.Conclusions. IYG significantly reduced 3 of 4 dating violence outcomes among ethnic-minority middle school youths. Although further study is warranted to determine if IYG should be widely disseminated to prevent dating violence, it is one of only a handful of school-based programs that are effective in reducing adolescent dating violence behavior.Adolescent dating violence is a serious public health concern in the United States. National estimates indicate that almost 10% of high school youths (9th–12th graders) are victims of physical dating violence,1 and more than 20% are victims of emotional dating violence.2 In addition to being associated with many negative health outcomes (i.e., substance abuse, suicide, depression, and sexual activity),3–8 adolescent dating violence may be predictive of intimate partner violence in adulthood,8–10 which has exceedingly high economic costs (particularly those related to health care).11 Thus, preventing adolescent dating violence may not only protect youths from severe health consequences, but also reduce the short- and long-term health costs associated with this type of violence.Although most research on adolescent dating violence focuses on high school youths, recent studies indicate that adolescent dating violence begins in middle school.12–14 For example, in a survey of seventh graders from diverse geographic locations, 37% reported being victims of psychological dating violence, and 15% reported being victims of physical dating violence in the last 6 months.14 Furthermore, there is mounting evidence that dating violence disproportionately affects ethnic-minority middle school youths. For instance, in a sample of multiethnic sixth graders from 4 US states, approximately one third of Hispanics and African Americans with a history of dating each reported physical dating violence perpetration, compared with only 14% of Whites.15 A similar racial/ethnic pattern emerged for physical dating violence victimization. Thus, it is becoming increasingly evident that dating violence is prevalent among middle school youths, especially among those who belong to ethnic-minority groups.Adolescent dating violence prevention programs are available, but only a few have been rigorously evaluated. Of these, only 2 school-based programs—Safe Dates and Fourth R: Skills for Youth Relationships (Fourth R)—have been shown to produce significant behavioral effects: both reduced dating violence perpetration or victimization.16–18 However, these programs may not be as effective in ethnic-minority middle school youths because they were developed for and evaluated in older, predominantly White youths. Of the relatively fewer dating violence programs developed for and evaluated in ethnic-minority youths, most have been shown to produce either no19 or inconsistent20 behavioral effects, or have been limited by a weak study design (i.e., lack of control group).21,22 Thus, there is a need for rigorously evaluated, effective dating violence prevention programs16 that specifically target younger, ethnic-minority youths.It’s Your Game…Keep It Real (IYG) is a health education program designed to delay sexual behavior and promote healthy dating relationships in ethnic-minority middle school youths. It is based on the premise that healthy relationships are foundational to healthy adolescent sexual health. In 2 previous randomized controlled trials, IYG was shown to be effective in delaying sexual initiation and reducing other sexual risk behaviors.23,24 An additional research question was whether IYG had an impact on emotional and physical dating violence perpetration and victimization. Thus, our goal was to determine if IYG reduces dating violence behavior among ethnic-minority middle school youths. We hypothesized that, by ninth grade, students who did not receive IYG would report more physical and emotional dating violence perpetration and victimization than students who did receive IYG.     

医专学生恋爱暴力与童年期虐待经历的关联

目的了解医学专科生恋爱暴力现况及其与不同形式童年期虐待的关联,为医学生恋爱暴力行为的防控提供依据。方法于2019年10-11月采用整群抽样的方法,以安徽省2所医学专科学校3727名有恋爱经历的一、二年级在校生为研究对象,了解一般人口统计学指标、童年期虐待和恋爱暴力等信息,分析不同形式童年期虐待与学生主动和被动恋爱暴力的关联。结果医学生主动恋爱暴力检出率为37.8%,被动恋爱暴力检出率为27.8%。女生童年期情感虐待检出率(61.9%)高于男生(51.6%),男生童年期躯体虐待(28.2%)和性虐待检出率(19.4%)高于女生(24.3%和10.5%)(χ~2值分别为33.84,6.33,52.97,P值均<0.01)。控制相关混杂因素的影响,童年期情感虐待、躯体虐待和性虐待均可能增加大学生恋爱关系中主动暴力[OR值(OR值95%CI)分别为1.71(1.48~1.98)、1.55(1.33~1.82)、1.75(1.43~2.15)]和被动暴力的风险[OR值(OR值95%CI)分别为1.84(1.43~2.16)、1.59(1.34~1.87)、1.62(1.32~2.00)](P值均<0.01)。童年期虐待和主被动恋爱暴力关联的强度性别间差异无统计学意义(P值均>0.05)。结论童年期虐待经历与医学生恋爱暴力的增加有关,减少童年期虐待有益于医学生恋爱暴力行为的防控。     

Relationships between hours of sleep and health-risk behaviors in US adolescent students

ObjectiveTo examine associations between insufficient sleep (< 8 h on average school nights) and health-risk behaviors.Methods2007 national Youth Risk Behavior Survey data of U.S. high school students (n = 12,154) were analyzed. Associations were examined on weighted data using multivariate logistic regression.ResultsInsufficient sleep on an average school night was reported by 68.9% of students. Insufficient sleep was associated with higher odds of current use of cigarettes (age-adjusted odds ratio [AOR], 1.67; 95% confidence interval [CI], 1.45–1.93), marijuana (AOR, 1.52; 95% CI, 1.31–1.76), and alcohol (AOR, 1.64; 95% CI, 1.46–1.84); current sexual activity (AOR, 1.41; 95% CI, 1.25–1.59); seriously considered attempting suicide (AOR, 1.86; 95% CI, 1.60–2.16); feeling sad or hopeless (AOR, 1.62; 95% CI, 1.43–1.84); physical fighting (AOR, 1.40; 95% CI, 1.24–1.60), not being physically active at least 60 min ≥ 5 days in the past 7 days (AOR, 1.16; 95% CI, 1.04–1.29), using the computer ≥ 3 h/day (AOR, 1.58; 95% CI, 1.38–1.80), and drinking soda/pop > 1 time/day (AOR, 1.14; 95% CI, 1.03–1.28).ConclusionTwo-thirds of adolescent students reported insufficient sleep, which was associated with many health-risk behaviors. Greater awareness of the impact of sleep insufficiency is vital.     

Associations Between Perceptions and Involvement in Neighborhood Violence and Intimate Partner Violence Perpetration Among Urban,African American Men

Violence disproportionately affects African American men and their communities. Research is needed to inform programming efforts to reduce racial/ethnic disparities in violence exposure, involvement, and victimization. The current study examined involvement in and perceptions of neighborhood violence and relation to perpetration of intimate partner violence (IPV) among a sample of urban, African American men. Participants of this cross-sectional study were sexually active African American men (n = 703) between the ages of 18 and 65 years, recruited from urban community health centers. Age-adjusted logistic regression models were used to assess associations between neighborhood violence variables and perpetration of IPV. In age-adjusted logistic regression models, involvement with street violence in the previous 6 months (Odds Ratio (OR) = 3.0; 95% Confidence Interval (CI): 1.9–4.6), ever being involved with gangs (OR = 2.0; 95% CI: 1.3–3.2), and perceptions/beliefs that violence occurs in one’s neighborhood (ORs = 2.0–3.1) were found to be significantly associated with IPV perpetration. Findings demonstrate that involvement in neighborhood violence as well as perceptions/beliefs that violence occurs in one’s neighborhood are associated with increased likelihood of IPV perpetration among urban, African American men. While socioeconomics and substance use contribute to high rates of these forms of violence, the relation between these forms of violence and perpetration of IPV was significant beyond the influences of these factors. Findings suggest that future violence prevention and treatment efforts will be most successful by addressing multiple forms of violence.     

Experiences of Racial Discrimination &; Relation to Violence Perpetration and Gang Involvement among a sample of Urban African American Men

Objective To examine racial discrimination and its relation to violence involvement among a sample of urban African American men. Methods Participants of this cross-sectional study were African American men (N = 703) between the ages of 18 and 65 years, recruited from four urban community health centers and two hospital-based clinics within an urban center in the Northeast. Multivariate logistic regression models were used to assess the relation of reported racial discrimination to recent perpetration of intimate partner violence (IPV), street violence involvement, and gang involvement. Racial discrimination was measured via 7 items assessing everyday and lifetime experiences of racial discrimination. Results In logistic regression models adjusted for age and homelessness, men reporting high levels of discrimination (scores above the sample median) were significantly more likely to report IPV perpetration (Adjusted Odds Ratio (AOR) = 1.9; 95% Confidence Interval (CI): 1.2–2.9) and street violence involvement (AOR = 1.5; 95% CI: 1.1–2.2) as compared to men reporting lower levels of discrimination. No relation was found between experiencing discrimination and gang involvement. Conclusions Findings showcase the potential relevance of racial discrimination to efforts focused on reducing racial disparities related to violence.     

Protective Factors for Sexual Violence: Understanding How Trajectories Relate to Perpetration in High School

Adolescent sexual violence (SV) perpetration is a significant public health problem. Many risk factors for perpetration are known, but less is known about what protects youth from perpetration, or how protective factors change over time. This longitudinal study reports trajectories of four potential protective factors for SV perpetration (empathy, parental monitoring, social support, and school belonging) across middle and high school and examines their relationship to SV perpetration in high school. Findings reveal that youth who identified as SV perpetrators had significantly lower mean empathy scores (d?=????0.18,?95?%?CI [?0.26,??0.10]) and social support scores (d?=????0.05,?95?%?CI [?0.14,??0.03]) at the beginning of middle school than non-perpetrators. We also found that youth who identified as SV perpetrators had a quicker deceleration in parental monitoring (slopes) and empathy from middle to high school, compared to non-perpetrators. Within-sex differences emerged; significant differences in slopes were detected for school belonging between male perpetrators and male non-perpetrators (Wald test?=?3.76 (1), p?=?.05) and between female perpetrators and female non-perpetrators (Wald test?=?3.95(1), p?=?.04). Significant differences in slopes for empathy between female perpetrators and female non-perpetrators (Wald test?=?4.76(1), p?=?.03) were also detected. No differences were found between male and female SV perpetrators for either empathy or school belonging. These findings have implications for the content and timing of adolescent SV prevention efforts. Intervention in adolescence, involving parents and schools in a comprehensive, multi-level approach, may be effective in preventing SV perpetration.     

School-Based Health Center Access,Reproductive Health Care,and Contraceptive Use Among Sexually Experienced High School Students

PurposeThe current analyses compared receipt of reproductive health care, contraceptive use, and screening for sexually transmitted diseases (STD) among adolescents who are sexually experienced, with or without access to a school clinic.MethodsA total of 12 urban California high schools, selected from areas with high teen pregnancy and STD rates, half with school-based health centers (SBHCs), participated in an intervention study designed to improve sexual health among adolescents. Of the participating students, 44% indicated that they had ever had intercourse and were included in these analyses.ResultsAccess to an SBHC did not influence receipt of reproductive health care for either males or females and did not influence contraceptive use, either hormonal or condoms, for males. For females, however, those with access to an SBHC had increased odds of having received pregnancy or disease prevention care (adjusted odds ratio [AOR] = 1.45, 95% confidence interval [CI] = 1.16–1.80), having used hormonal contraceptives at last sex (AOR = 1.68, 95% CI = 1.24–2.28), and were more likely to have ever been screened for an STD (AOR = 1.85, 95% CI = 1.43–2.40). Also among female students, those with access to an SBHC were more likely to have used emergency contraception at last sex (AOR = 2.1, 95% CI = 1.08–4.22).ConclusionAlthough access to an on-site clinic does not seem to lead to increases in all types of reproductive care in the population as a whole, sexually active females are more likely to have received more specific care and to have used hormonal contraceptives if their school has an SBHC.     

Parental predictors of HPV vaccine initiation among low-income Hispanic females aged 11–17 years

PurposeHispanic women experience a disproportionate burden of cervical cancer morbidity and mortality compared to non-Hispanic women. Increasing HPV vaccination among Hispanic adolescents can help alleviate disparities. This study aimed to identify parental psychosocial predictors associated with HPV vaccine initiation and correlates of parental intentions to obtain the vaccine for their Hispanic adolescent daughters aged 11–17 years.MethodsThis study is part of a larger three-arm randomized controlled trial testing the effectiveness of interventions to increase HPV vaccination. Parents of adolescent females were recruited in community clinics where we conducted baseline surveys. We obtained electronic medical records six months after baseline to assess vaccination status. Multilevel logistic regression was used to identify correlates of parental intentions to vaccinate and predictors of HPV vaccine initiation. Analyses with initiation as the outcome also controlled for intervention study arm. The Integrated Behavioral Model guided selection of psychosocial and outcome variables.ResultsOur sample (n = 765) consisted mostly of mothers with less than a high school education born outside of the U.S. Forty-one percent had a household income less than $15,000. Most daughters had public or private insurance. Twenty-one percent initiated the HPV vaccine series. Correlates of intention to vaccinate intention included subjective norms related to daughter’s doctor (AOR = 1.04; 95% CI 1.01–1.07), belief that the vaccine is safe (AOR = 1.38; 95% CI 1.06–1.78), self-efficacy to obtain the vaccine for their daughter (AOR = 2.39; 95% CI 1.52–3.77), and parental concern about vaccine side effects (AOR = 0.73; 95% CI 0.60–0.89). Intentions predicted initiation (AOR = 2.01; 95% CI 1.10–5.26); concern about sexual disinhibition decreased the odds of having a vaccinated daughter at follow-up (AOR = 0.66; 95% CI 0.47–0.92).DiscussionParental intention and concerns about sexual disinhibition predict vaccine initiation. Further research is needed to explore the role of intention as a potential mediator between psychosocial variables and vaccination status.     

Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes

Teen dating violence and sexual violence are severe public health problems. Abusive behaviors within the context of dating or romantic relationships are associated with adverse health outcomes. Promoting positive bystander intervention and increasing knowledge of abusive behaviors are promising strategies for preventing dating and sexual violence. Coaching Boys Into Men (CBIM) is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes. Identifying specific barriers and facilitators based on the coaches’ experiences with program delivery combined with the coaches’ and athletes’ program perceptions may help optimize future CBIM implementation and sustainability. Semi-structured interviews with coaches (n?=?36) explored the implementers’ perspectives on strategies that worked well and potential barriers to program implementation. Ten focus groups with male athletes (n?=?39) assessed their experiences with CBIM and the suitability of having their coaches deliver this program. Coaches described using the CBIM training cards and integrating program delivery during practice. Athletes reported coaches routinely delivering the CBIM program and adding their own personal stories or examples to the discussions. Key facilitators to program implementation include support from the violence prevention advocate, the ease of integrating CBIM into the sports season, and using the program materials. Barriers to implementation included finding sufficient time for the program, dynamics of delivering sensitive program content, and participant constraints. Coaches and athletes alike found the program feasible and acceptable to implement within the sports setting. Both coaches and athletes offered insights on the implementation and the feasibility and acceptability of CBIM within school-based athletic programs. These experiences by implementers and recipients alike can inform future dissemination and implementation efforts of CBIM. Further, by pinpointing where and how coaches were successful in implementing the program and what resonated with athletes, can help better understand how CBIM is effective in promoting athletes to stop violence against women and girls. Coach and athlete reflections on CBIM implementation provide insights for optimizing future program delivery and dissemination.     

Painfully Obvious: A Longitudinal Examination of Medical Use and Misuse of Opioid Medication Among Adolescent Sports Participants

PurposeThe objective of this longitudinal study was to assess the prevalence of medical use, medical misuse, and non-medical use of opioid medication among adolescents who participate in organized sports.MethodsData for this study were taken from the Secondary Student Life Survey. A total of 1,540 adolescents participated in three waves of data collection occurring between the 2009–2010 and 2011–2012 school years, with 82% of the baseline sample completing all three waves.ResultsUsing generalized estimating equation models to analyze the longitudinal data, it was found that male adolescents who participated in organized sports during each wave of the Secondary Student Life Survey had higher odds of being prescribed an opioid medication (i.e., medical use) during the past year (adjusted odds ratio [AOR], 1.86; 95% confidence interval [CI], 1.23–2.82), higher odds of past-year medical misuse of opioid medication as a result of taking too much (AOR, 10.5; 95% CI, 2.42–45.5), and higher odds of past-year medical misuse of opioid medication to get high (AOR, 4.01; 95% CI, 1.13–14.2) compared with males who did not participate in organized sports during the study period. Among females, no association was found between participation in organized sports and medical use, medical misuse, and non-medical use of opioid medication.ConclusionsThe results of this study indicate that adolescent males who participate in sports may have greater access to opioid medication, which puts them at greater risk to misuse these controlled substances.     

Problematic Situations Associated with Dating Experiences and Relationships Among Urban African American Adolescents: A Qualitative Study

This qualitative study focused on the identification of problem situations associated with adolescent dating experiences and relationships, including those that placed youth at risk for dating violence perpetration or victimization. Interviews were conducted with 44 African American middle and high school students in an urban school system. Qualitative analysis identified 18 individual themes representing six categories of problem situations: (a) approach and initiation; (b) conflict, conflict resolution, and break-ups; (c) communication, connection, and emotion; (d) aggression and victimization; (e) the role of others; and (f) media and technology. Identification of these problem situation themes has important implications for developing and evaluating prevention efforts designed to foster healthy adolescent dating relationships.     

Adolescent Experiences of Violence and Relation to Violence Perpetration beyond Young Adulthood among an Urban Sample of Black and African American Males

The purpose of this study is to determine if experiences of physical violence during early and late adolescence (12–21 years) places urban Black males at increased risk for interpersonal violence perpetration beyond young adulthood (30 years and older). Participants of this cross-sectional study were Black and African American men (N = 455) between the ages of 30 and 65 years, recruited from four urban clinical sites in the Northeast. Multivariate logistic regression models were used to analyze the relation of adolescent experiences of violence to: (1) past 6 month street violence involvement and (2) past year intimate partner violence perpetration. Ten percent of the sample reported that they experienced adolescent victimization. Men reporting adolescent victimization were significantly more likely to report past 6-month street violence involvement (Adjusted Odds Ratio (AOR) = 3.2, 95 % CI = 1.7–6.3) and past 6 month intimate partner violence perpetration (AOR = 2.8, 95 % CI = 1.8–5.4) compared to men who did not report such victimization. Study findings suggest that in order to prevent adulthood perpetration of violence, more work is needed to address experiences of victimization among young Black males, particularly violence experienced during adolescence.